Irreversible Acute Renal Failure after Extracorporeal Shock-Wave Lithotripsy

Díaz-Tejeiro, Rafael; Díaz, Eugenio García; Fernández, Gema; Gonzalez, E.; García, Manuel Ángel Caro; Ahijado, F.; Gómez, Estrella Díaz; T, Sierra; Iglesias, A.

doi:10.1159/000187198

Cited by 3 publications

(2 citation statements)

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“…The same mechanical forces that comminute stones, however, also contribute to renal injuries [14][15][16]. It has been widely reported that SWL-induced injuries range from selflimited trauma to potentially life-threatening complications [17][18][19]. In particular, with much increased output acoustic pressure, contemporary lithotripters have high propensity for renal vascular injuries [20,21].…”

Section: Introductionmentioning

confidence: 99%

Simultaneous Photoacoustic Imaging and Cavitation Mapping in Shockwave Lithotripsy

Yao

Lan

et al. 2020

IEEE Trans. Med. Imaging

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Kidney stone disease is a major health problem worldwide. Shockwave lithotripsy (SWL), which uses high-energy shockwave pulses to break up kidney stones, is extensively used in clinic. However, despite its noninvasiveness, SWL can produce cavitation in vivo. The rapid expansion and violent collapse of cavitation bubbles in small blood vessels may result in renal vascular injury. To better understand the mechanism of tissue injury and improve treatment safety and efficiency, it is highly desirable to concurrently detect cavitation and vascular injury during SWL. Current imaging modalities used in SWL (e.g., C-arm fluoroscopy and B-mode ultrasound) are not sensitive to vascular injuries. By contrast, photoacoustic imaging is a non-invasive and nonradiative imaging modality that is sensitive to blood, by using hemoglobin as the endogenous contrast. Moreover, photoacoustic imaging is also compatible with passive cavitation detection by sharing the ultrasound detection system. Here, we have integrated shockwave treatment, photoacoustic imaging and passive cavitation detection into a single system. Our experimental results on phantoms and in vivo small animals have collectively demonstrated that the integrated system is capable of capturing shockwave-induced cavitation and the resultant vascular injury simultaneously. We expect that the integrated system, when combined with our recently developed internal-light-illumination photoacoustic imaging, will find important applications for monitoring shockwave-induced vascular injury in deep tissues during SWL.

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Section: Introductionmentioning

confidence: 99%

Simultaneous Photoacoustic Imaging and Cavitation Mapping in Shockwave Lithotripsy

Yao

Lan

et al. 2020

IEEE Trans. Med. Imaging

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“…SWL also typically promotes transient impairment of GFR and renal plasma flow (RPF) in human patients (4 -10) and experimental animals (11)(12)(13). Results of longer-term studies suggest that the impairment of renal hemodynamics may be permanent (2), and at least one clinical report links SWLinduced renal injury to the development of irreversible acute renal failure (14). Other reports link shock-wave-induced injury to the subsequent development of new-onset hypertension (3,9,15,16) or worsened preexisting hypertension.…”

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confidence: 99%

Relationship between Kidney Size, Renal Injury, and Renal Impairment Induced by Shock Wave Lithotripsy

Willis¹,

Evan²,

Connors³

et al. 1999

Journal of the American Society of Nephrology

112

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Abstract. The relationship between kidney size and impaired renal function induced by shock-wave lithotripsy (SWL) was examined in 6- and 10-wk-old anesthetized pigs. Each pig received 2000 shock waves, 24 kV, or sham SWL to the lower pole calyx of one kidney. Bilateral GFR, renal plasma flow (RPF), and para-aminohippurate extraction was measured 1 h before and 1 and 4 h after SWL. The kidneys were then removed for morphometric analysis. Mean kidney weights were 66.1 ± 2.7 g (n = 9) and 103.1 ± 3.3 g (n = 8) in the SWL groups, and 60.1 ± 2.6 g (n = 9) and 82.3 ± 4.0 g (n = 9) in the sham-SWL groups. SWL-induced lesions occupied a significantly greater volume of the small kidneys (6.1 ± 1.7 vol % versus 1.5 ± 0.2 vol % in the large kidneys). RPF was significantly reduced by SWL in small and large kidneys, but to a significantly greater extent in small kidneys. RPF was also significantly reduced in the contralateral kidneys of both groups, but only at 1 h after SWL. SWL significantly reduced GFR to similar degrees in both kidneys of both groups, regardless of kidney size. Para-aminohippurate extraction was likewise reduced to similar degrees in both groups, but this effect was evident only in the SWL-treated kidneys, and only in the pole to which the shock waves had been applied. The injury induced by SWL affected a larger fraction of small kidneys than large ones, and the renal vasoconstriction induced by SWL was greatest in small kidneys.

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Extracorporeal Shock Wave Lithotripsy and Percutaneous Nephrolithotomy

Gravenstein¹

2000

Anesthesiology Clinics of North America

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Irreversible Acute Renal Failure after Extracorporeal Shock-Wave Lithotripsy

Cited by 3 publications

References 2 publications

Simultaneous Photoacoustic Imaging and Cavitation Mapping in Shockwave Lithotripsy

Simultaneous Photoacoustic Imaging and Cavitation Mapping in Shockwave Lithotripsy

Relationship between Kidney Size, Renal Injury, and Renal Impairment Induced by Shock Wave Lithotripsy

Extracorporeal Shock Wave Lithotripsy and Percutaneous Nephrolithotomy

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